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General NPI Number Information
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NPI Number | 1447241724
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Entity Type | Individual
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Provider Name | AURELIO J COLLAZO R.PH.
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Gender | Male
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Dates
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Enumeration Date | 11/04/2005
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Last Update Date | 03/20/2008
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Provider Practice Location Address
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Address Line | 4000 SW 57TH AVE
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City | SOUTH MIAMI
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State | FL
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Zip | 33155-5318
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Country | US
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Telephone | 305-666-8581
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Fax | 305-661-9653
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Provider Business Mailing Address
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Address Line | 4000 SW 57TH AVE
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City | MIAMI
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State | FL
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Zip | 33155-5318
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Country | US
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Telephone | 305-666-0057
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Fax | 305-661-9653
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 183500000X
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Taxonomy Name | Pharmacist
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License Number | PS17897
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License Number State | FL
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